How Dental Can Start Thinking “Lean”
When You Hear “Lean” Referred to In Business, What First Comes to Mind?
It may be images of finely tuned systems and machinery in automotive or aerospace manufacturing plants. Or perhaps streamlined processes that allow businesses to lower costs and run more efficiently. Either way, your line of thinking would be accurate. After all, the lean methodology gained prominence when Toyota used it to design their production system to optimize productivity and reduce waste.
Why Is Lean Relevant to Dental?
In short, lean principles can help dental practices better adapt to the challenges currently facing the industry. For example, declining PPO reimbursements, rising education debt, increasing technology capital expense, accelerating DSO “large chain” competition, and a consumer base with increasingly more options for dental services. By implementing lean, one can help reduce wasteful elements of your practice as well as increase focus on value additive processes and, in turn, increase efficiency, productivity, and profitability. All which allows you to continually provide a superior patient experience.
Lean Principles for Dental
Below are the lean principles and practices that would most apply to the dental industry. And as you’ll see, these are sound business practices (and in many ways common sense) that almost any dental practice could benefit from.
Refining Processes:
For a dentist, refining processes is accomplished by constantly measuring all your actions across every part of your service chain – from clinical, to practice management, to team dynamics – against how much actual value is being provided to your patients. This helps bring to light what you’re doing that’s helping you deliver a better experience to the them, and what’s not. The goal being you continually add to and increase the value actions and find ways to eliminate the non-value ones. And this should involve the entire scope of the patient experience from the time they get scheduled through checkout.
Reducing Waste:
You may think of reducing waste, or even “lean”, as finding ways to operate with the least amount of costs and expenses possible. However, it’s really about increasing efficiency and productivity by learning how to operate with what you need, in the amounts you need, when you need it. Lean implores you to take a hard look at possible wastes in your practice – materials, people, time – which can be easy to overlook during the daily grind of trying to run the business.
Always Looking to Get Better:
One of the cornerstone concepts of lean is called kaizen, which is an idea that improvement is a constant process that needs continual attention and care. To use this approach means your open to new ideas and ways of doing things. The opposite of kaizen would be the attitude “we’ll continue to do it this way, because it’s the way we’ve always done it”. For instance, as small business owners, it’s easy for dentists to get stuck in their ways and become averse to new ideas unless they have a system in place that helps them safeguard against those types of habits.
Making Informed Business Decisions:
Another element associated with kaizen is that management is in tune with what’s going on at the “ground level” of the business. This would be important concept for dentists to follow because it can be easy to lose a handle on what’s going on in your practice given all the responsibilities you shoulder. It would help you make more confident and accurate decisions knowing you’re basing them off real facts and scenarios, rather than guesses or hearsay. Plus, as the business owner and leader, it would mean taking ownership of how things are done in your practice. And if there are problems or issues that need to be addressed, you proactively work to find the central causes, so they can be rectified (permanently) as soon as possible. Additionally, management empowers employees to take the same approach, so there’s a residual effect of taking ownership and effective problem solving.
Putting Patients First:
Customers are the ultimate focal point within the lean methodology. The main reason lean is implemented in the first place, is to allow your business to deliver as much value to them as possible. A large part of what this means for dentist is making it easy for your patients to get what they want from you. And to have this approach is almost a must in today’s market. Because all consumer’s expectations (including your patients) have never been higher. Everything is at their fingertips. Instant gratification is now the norm, so much so that they’ve developed a heightened awareness and sensitivity for delays, disruptions, and inefficiencies in their purchase experiences. Lean helps you give them the experience they want, while helping your business run like a finely oiled machine. It’s the ultimate win-win situation for you and your patients.
Technology
Technology itself is not a lean concept. However, it plays an important role because it allows you to deliver more value to the patient, such as faster service like the ones achieved with single visit dentistry, better results, and more accurate diagnoses. Plus, it can help reduce wasted time and materials as well as avoid mistakes. But it’s important to remember, technology is a compliment to lean thinking, it helps you better execute. Meaning just because you load up your office with a bunch of equipment or tech, doesn’t make you automatically lean. Be strategic about it. For instance, first identify areas where you can improve efficiency and productivity to provide more value for your patients. Then find the equipment that can help you in those specific areas. Plus, it’s important to note, lean is a mindset and way of thinking, so it can typically be applied with very little financial investment.
People
Sometimes there can be a misconception that lean only applies to systems and processes. But in reality, it’s the people that make it go and this is for a couple of reasons. First, people drive the initial implementation of lean as well as keep it moving forward and producing results. And second, incorporating lean principles into the human element creates similar opportunities for waste reduction and increased productivity as it does when applying it to processes.
Two important overarching components to connecting lean with people is management philosophy and office culture. When it comes to management, lean stresses a “a bottom up” approach. This is because lean leaders know that the feedback and input from employees closest to the actual work should be heavily considered in decisions. And culture is important because in order for lean to be successfully applied, the values and beliefs need to be consistent throughout every job function and department.
Encourage Independent Problem Solving
Lean stresses to train employees to be independent so that they handle more problems and issues on their own. The goal here is to reduce the frequency in which an employee must stop their task to get help or ask a question. Increasing employee problem solving ability, even by a small amount, can show significant returns, such as improved workflow, time savings, and increased production. Lean also emphasizes finding the root causes of issues, rather than just “quick fixes”, to ensure problems are resolved the first time and don’t reoccur. Over time this habit will reduce, and eventually eliminate, many types of mistakes and inaccuracies from happening in the first place.
Don’t Operate In “Silos”
As in any business, your practice consists of different departments performing different tasks (i.e. hygiene, front desk, assistants). And as is often the case through the daily grind, the different departments can get overly focused on only their specific job function. Lean recommends companies operating as cohesive units to reduce waste, create efficiencies, and deliver the best possible service to the customer. However, this is difficult to achieve when different departments are operating without much knowledge or thought on how their work connects with that of other departments. This is especially important for your patient experience. Because if all your employees, from hygiene to the front desk, are not in sync, the patient notices.
Find Your Champions for Change
Whether you’re trying to introduce lean concepts into your practice, or any change for that matter, you will need to find those team members that will be your advocates. If you don’t already have established leaders in your practice, you’ll need to focus on identifying those who seem most suitable and then discuss the role you want them to play.
A process to have your champion implement so that they can experience the benefit, and then relay it to the other members, is the five Ss – sort, straighten, scrub, systemize, and standardize. All these boil down to creating processes that are organized, refined, logically arranged, and consistently executed to produce a consistent result.
An effective method to initially implement the five Ss is by asking your champion(s) to date-mark various supplies and equipment in their workspace, whether it be a desk or operatory, with a tag or label. And then update the date on the tag each time a respective item is used. The goal is to separate out those supplies and equipment that are used every day from those that are either occasionally or never used. This ultimately allows for an efficient workspace arrangement, where the most frequently used items are the handiest, and everything else is stored or removed all together.
Maintain Your Human Assets
In a later series practice management, we will discuss the importance of correctly and proactively maintaining your capital equipment to avoid breakdown (total productive maintenance). The same goes for your people. Because just like equipment can breakdown if not properly maintained, so too can your human capital, in the way of low morale and accountability as well as frustration and resentment. That’s why lean principles stress the importance of holding your employees in high regard. And it’s not just about treating them the right way. It’s also about leveraging their full abilities so that your practice can reach its full potential.
Your team is an important asset, so you need to routinely invest in them. This includes everything from CE trainings to simply telling them how much you appreciate them and how important they are to the overall success and growth of the business.
Areas of Lean Application in Dental
In an upcoming article series, we’ll be taking a deep dive into two additional dental-specific areas where the lean methodology could be practically applied: Clinical and Practice Management
About the Author
Alex Sadusky currently serves as the Chief Executive Officer of Dental Card Services Alliance, LLC (www.dentalcardservices.com), an organization he co-founded in 2009. Dental Card Services Alliance is the exclusive credit card processing services provider of the AGD Exclusive Benefits program and has numerous other endorsements, alliances, and associations.
Prior to resuming the role as the CEO of Dental Card Services, Mr. Sadusky was Vice President Office of the CEO for Dentsply Sirona, the world’s largest dental consumable and equipment provider. In his previous roles with Dentsply Sirona, Mr. Sadusky was responsible for corporate strategy and business development, specialty markets, and strategic projects.
Prior to joining legacy Sirona Dental, Mr. Sadusky spent over 15 years of experience in investment banking, venture capital, private equity, management consulting and corporate business development.